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STATE LEVEL POLICE RECRUITMENT BOARD
            ANDHRA PRADESH, HYDERABAD                                                       Registration No.
                                                                                      (to be filled by office only)
                Application form for the posts of
   Stipendiary Cadet Trainee Police Constables (APSP) (Men)
                       in 15th Bn., APSP

                                 NOTE:
   1. Please fill the application form after carefully reading the
                                                                                             Paste here firmly a
      โ€œINSTRUCTIONS FOR FILLING THE APPLICATION
                                                                                           signed recent passport
      FORMโ€
                                                                                           size colour photograph
   2. Suppression or concealment of facts will result in
      disqualification
   3. The candidate should not submit more than one application for
      this recruitment


1. Name of the candidate (in capital letters):




2. Fatherโ€™s name (in capital letters):




                                                              Date               Month                       Year
3. Date of birth:


4. Community
   (Refer para 5(a) of the instructions for codes)

5. a) Do you belong to Aboriginal Tribes in the scheduled area ?
      (Write โ€˜1โ€™ for Yes, โ€˜2โ€™ for No)

  b) If yes, have you submitted relevant Certificate ?
     (Write โ€˜1โ€™ for Yes, โ€˜2โ€™ for No)

   c) Details of scheduled area at which candidate domiciled ?

            House No.: _________________________                Street: _____________________________

            Village: ____________________________ Mandal: ___________________________

            District: ____________________________ Pincode:

6. Educational qualification

                                                     PC Rect.2011 in 15th Bn., APSP โ€“ 929/R&T/Rect.1/2011 dt 19-10-2011
(Refer para 5(b) of the instructions for codes)

7. Age relaxation:

     a) Indicate the code if you belong to any of
        the categories referred to in para 5(c) of
        the instructions

     c) If so, have you submitted relevant certificates ?
        (Write โ€˜1โ€™ for Yes, โ€˜2โ€™ for No)

8. Furnish the details if you are an employee of the A.P. Govt. (for age relaxation):

                                                                     Date             Month                    Year
     a) Date of joining service


                                                                     Years           Months             Days
     b) Length of service as on 01-07-2011


     c) Are you still in service
        (Write โ€˜1โ€™ for Yes, โ€˜2โ€™ for No)

9. Furnish the details if you served as an employee in the Army, Naval or Air Force of the Union
    (for age relaxation):
                                                             Date       Month              Year
    a) Date of entry


                                                                     Date             Month                    Year
     b) Date of discharge


                                                                     Years           Months             Days
     c) Total service rendered


10. Furnish the details if you worked as an instructor in NCC (for age relaxation):

                                                                     Date             Month                    Year
     a) Date of entry


                                                                     Date             Month                    Year
     b) Date of discharge


                                                                     Years           Months             Days
     c) Total service rendered



2                                                     PC Rect.2011 in 15th Bn., APSP โ€“ 929/R&T/Rect.1/2011 dt 19-10-2011
11. Identification marks:              1.
                                       2.

12. Present Postal address for purpose of communication (in capital letters):

Name: ____________________________________________

S/o / D/o / W/o / C/o: ________________________________
House No.: ____________________________________         Street: _______________________
Village: ______________________________________         Mandal: ______________________
District: _______________________________________       Pin Code:

Contact Ph No.:        Cell, if any: ______________________________
                       Landline, if any: __________________________

                                   LIST OF DOCUMENTS ENCLOSED

1. Proof of date of birth                                    6. A.P. Govt. employee service certificate

2. Educational qualification                                 7. Service certificate in the Army, Naval or
                                                                Air Force of the Union

3. Higher educational qualification, if any                  8. NCC Instructor service certificate


4. ST Community certificate (Annexure III)                   9. Retrenched temporary employee certificate
                                                                in the State Census Department

5. Proof of residence certificate in the                     10. Any other documents
   scheduled area for Aboriginal Tribes

                                 DECLARATION OF THE CANDIDATE

I have read the provisions in the rules and notification of the State Level Police Recruitment Board and the
instructions carefully and hereby undertake to abide by them. I further declare that I have not been debarred
from appearing in any examination.

I declare that I fulfill all the conditions of eligibility regarding age limits, educational qualifications etc.
prescribed for admission to the examination.

I hereby declare that all statements made in this application are true, complete and correct to the best of my
knowledge and belief. I understand that in the event of any information being found to be false or incorrect or
incomplete as that I have suppressed any information or that I do not satisfy the eligibility criteria, my
candidature for the selections is liable to be rejected or cancelled and even after appointment, my services are
liable to be terminated without any notice. I am willing to serve anywhere in A.P. / India, if selected.


Place:

Date:                                                                          Signature of Candidate

                                            FOR OFFICE USE ONLY

Place:


3                                                     PC Rect.2011 in 15th Bn., APSP โ€“ 929/R&T/Rect.1/2011 dt 19-10-2011
Date:                                                                    Signature of Chief Superintendent


                    INSTRUCTIONS FOR FILLING THE APPLICATION FORM

1.      Candidates must ensure that no relevant column is left blank or wrongly filled. Applications not filled
        correctly, completely and as per the instructions are liable to be rejected at any stage

2.      They must fill the application in their own handwriting using Blue / Black ball point pen without
        touching the border lines. eg.:

                                          A    B   C      D    1     2    3     4

3       They need to write the relevant code in the boxes i.e., A1, B2 etc. wherever applicable in the following
        manner

                                                   A      1         B     2

4.      Copies of the documents as stated in para 17(2) of the Notification must be enclosed in support of the
        information given in the form where necessary along with the entire application form (4 pages) and

        Failure to enclose the same will lead to rejection of the application form

5.      CODES:

(a) Codes for Col. 4 of the application form
Category       Code          Category        Code              Category             Code           Category            Code
OC             A01           BC-B            C03               BC-D                 E05            SC                  G07
BC-A           B02           BC-C            D04               BC-E                 F06            ST                  H08

(b) Codes for Col. 6 of the application form
Educational qualification                 Code                Educational qualification                              Code
9th Class                                  A1                 Intermediate                                            C3
SSC or equivalent                           B2                Degree & above                                          D4

(c) Codes for Col. 7 of the application form
Category                                           Code            Category                                           Code
A.P. State Govt. employee                           A1             Retrenched temporary employee in                    D4
Worked in the Army, Naval or Air Force of           B2             the State Census Department
the Union                                                          None of the above                                   E5
Working as NCC instructor                          C3




                                                                                                CANDIDATE COPY
          STATE LEVEL POLICE RECRUITMENT BOARD
               ANDHRA PRADESH, HYDERABAD                                                       Registration No.
                                                                                         (to be filled by office only)
             Identity Card (Candidate copy) for the posts of




4                                                       PC Rect.2011 in 15th Bn., APSP โ€“ 929/R&T/Rect.1/2011 dt 19-10-2011
SCT Police Constables (APSP) (Men) in 15th Bn., APSP
                      in Police Department


1. Name of the candidate :

2. Fatherโ€™s Name:



                                                                                      Paste here firmly a
                                                                                    signed recent passport
    3. Signature of the candidate      4. Signature of the Chief                    size colour photograph
                                          Superintendent
5. Identification marks:
   a)
   b)

Name of the        Date & Time      Venue of the test                                  Result
Test
6. Preliminary
selection test                                                        Qualified              Not Qualified
( 3 km run in 25
minutes)




Office Seal & Date                                          Signature of the Chief Superintendent
7. Physical
measurement                                                           Qualified              Not Qualified
test




Office Seal & Date                                          Signature of the Chief Superintendent
8. Physical
efficiency test                                                        Attended              Not Attended




Office Seal & Date                                          Signature of the Chief Superintendent

                                         INSTRUCTIONS


Stage I : Preliminary Selection Test

Candidates will have to run three (3) kms. within 25 minutes




5                                               PC Rect.2011 in 15th Bn., APSP โ€“ 929/R&T/Rect.1/2011 dt 19-10-2011
Stage II : Physical Efficient Test

Candidates will have to participate five (5) events i.e., 100 mtrs. run, long jump, shot put, high jump
and 800 mtrs. run


All candidates hereby advised to get themselves examined by physician and satisfy themselves
that they are fit enough to participate in state I and stage II of the selection process




                                                                                                  OFFICE COPY
       STATE LEVEL POLICE RECRUITMENT BOARD
            ANDHRA PRADESH, HYDERABAD                                                    Registration No.
                                                                                   (to be filled by office only)
           Identity Card (Office copy) for the posts of
      SCT Police Constables (APSP) (Men) in 15th Bn., APSP
                      in Police Department




6                                                 PC Rect.2011 in 15th Bn., APSP โ€“ 929/R&T/Rect.1/2011 dt 19-10-2011
1. Name of the candidate :

2. Fatherโ€™s Name:



                                                                                      Paste here firmly a
                                                                                    signed recent passport
    3. Signature of the candidate     4. Signature of the Chief                     size colour photograph
                                         Superintendent
5. Identification marks:
   a)
   b)

Name of the        Date & Time      Venue of the test                                  Result
Test
6. Preliminary
selection test                                                        Qualified              Not Qualified
( 3 km run in 25
minutes)




Office Seal & Date                                          Signature of the Chief Superintendent
7. Physical
measurement                                                           Qualified              Not Qualified
test




Office Seal & Date                                          Signature of the Chief Superintendent
8. Physical
efficiency test                                                        Attended              Not Attended




Office Seal & Date                                          Signature of the Chief Superintendent




7                                               PC Rect.2011 in 15th Bn., APSP โ€“ 929/R&T/Rect.1/2011 dt 19-10-2011

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6. police constables rect. 2011 in 15th bn., apsp application form - 7 pages

  • 1. STATE LEVEL POLICE RECRUITMENT BOARD ANDHRA PRADESH, HYDERABAD Registration No. (to be filled by office only) Application form for the posts of Stipendiary Cadet Trainee Police Constables (APSP) (Men) in 15th Bn., APSP NOTE: 1. Please fill the application form after carefully reading the Paste here firmly a โ€œINSTRUCTIONS FOR FILLING THE APPLICATION signed recent passport FORMโ€ size colour photograph 2. Suppression or concealment of facts will result in disqualification 3. The candidate should not submit more than one application for this recruitment 1. Name of the candidate (in capital letters): 2. Fatherโ€™s name (in capital letters): Date Month Year 3. Date of birth: 4. Community (Refer para 5(a) of the instructions for codes) 5. a) Do you belong to Aboriginal Tribes in the scheduled area ? (Write โ€˜1โ€™ for Yes, โ€˜2โ€™ for No) b) If yes, have you submitted relevant Certificate ? (Write โ€˜1โ€™ for Yes, โ€˜2โ€™ for No) c) Details of scheduled area at which candidate domiciled ? House No.: _________________________ Street: _____________________________ Village: ____________________________ Mandal: ___________________________ District: ____________________________ Pincode: 6. Educational qualification PC Rect.2011 in 15th Bn., APSP โ€“ 929/R&T/Rect.1/2011 dt 19-10-2011
  • 2. (Refer para 5(b) of the instructions for codes) 7. Age relaxation: a) Indicate the code if you belong to any of the categories referred to in para 5(c) of the instructions c) If so, have you submitted relevant certificates ? (Write โ€˜1โ€™ for Yes, โ€˜2โ€™ for No) 8. Furnish the details if you are an employee of the A.P. Govt. (for age relaxation): Date Month Year a) Date of joining service Years Months Days b) Length of service as on 01-07-2011 c) Are you still in service (Write โ€˜1โ€™ for Yes, โ€˜2โ€™ for No) 9. Furnish the details if you served as an employee in the Army, Naval or Air Force of the Union (for age relaxation): Date Month Year a) Date of entry Date Month Year b) Date of discharge Years Months Days c) Total service rendered 10. Furnish the details if you worked as an instructor in NCC (for age relaxation): Date Month Year a) Date of entry Date Month Year b) Date of discharge Years Months Days c) Total service rendered 2 PC Rect.2011 in 15th Bn., APSP โ€“ 929/R&T/Rect.1/2011 dt 19-10-2011
  • 3. 11. Identification marks: 1. 2. 12. Present Postal address for purpose of communication (in capital letters): Name: ____________________________________________ S/o / D/o / W/o / C/o: ________________________________ House No.: ____________________________________ Street: _______________________ Village: ______________________________________ Mandal: ______________________ District: _______________________________________ Pin Code: Contact Ph No.: Cell, if any: ______________________________ Landline, if any: __________________________ LIST OF DOCUMENTS ENCLOSED 1. Proof of date of birth 6. A.P. Govt. employee service certificate 2. Educational qualification 7. Service certificate in the Army, Naval or Air Force of the Union 3. Higher educational qualification, if any 8. NCC Instructor service certificate 4. ST Community certificate (Annexure III) 9. Retrenched temporary employee certificate in the State Census Department 5. Proof of residence certificate in the 10. Any other documents scheduled area for Aboriginal Tribes DECLARATION OF THE CANDIDATE I have read the provisions in the rules and notification of the State Level Police Recruitment Board and the instructions carefully and hereby undertake to abide by them. I further declare that I have not been debarred from appearing in any examination. I declare that I fulfill all the conditions of eligibility regarding age limits, educational qualifications etc. prescribed for admission to the examination. I hereby declare that all statements made in this application are true, complete and correct to the best of my knowledge and belief. I understand that in the event of any information being found to be false or incorrect or incomplete as that I have suppressed any information or that I do not satisfy the eligibility criteria, my candidature for the selections is liable to be rejected or cancelled and even after appointment, my services are liable to be terminated without any notice. I am willing to serve anywhere in A.P. / India, if selected. Place: Date: Signature of Candidate FOR OFFICE USE ONLY Place: 3 PC Rect.2011 in 15th Bn., APSP โ€“ 929/R&T/Rect.1/2011 dt 19-10-2011
  • 4. Date: Signature of Chief Superintendent INSTRUCTIONS FOR FILLING THE APPLICATION FORM 1. Candidates must ensure that no relevant column is left blank or wrongly filled. Applications not filled correctly, completely and as per the instructions are liable to be rejected at any stage 2. They must fill the application in their own handwriting using Blue / Black ball point pen without touching the border lines. eg.: A B C D 1 2 3 4 3 They need to write the relevant code in the boxes i.e., A1, B2 etc. wherever applicable in the following manner A 1 B 2 4. Copies of the documents as stated in para 17(2) of the Notification must be enclosed in support of the information given in the form where necessary along with the entire application form (4 pages) and Failure to enclose the same will lead to rejection of the application form 5. CODES: (a) Codes for Col. 4 of the application form Category Code Category Code Category Code Category Code OC A01 BC-B C03 BC-D E05 SC G07 BC-A B02 BC-C D04 BC-E F06 ST H08 (b) Codes for Col. 6 of the application form Educational qualification Code Educational qualification Code 9th Class A1 Intermediate C3 SSC or equivalent B2 Degree & above D4 (c) Codes for Col. 7 of the application form Category Code Category Code A.P. State Govt. employee A1 Retrenched temporary employee in D4 Worked in the Army, Naval or Air Force of B2 the State Census Department the Union None of the above E5 Working as NCC instructor C3 CANDIDATE COPY STATE LEVEL POLICE RECRUITMENT BOARD ANDHRA PRADESH, HYDERABAD Registration No. (to be filled by office only) Identity Card (Candidate copy) for the posts of 4 PC Rect.2011 in 15th Bn., APSP โ€“ 929/R&T/Rect.1/2011 dt 19-10-2011
  • 5. SCT Police Constables (APSP) (Men) in 15th Bn., APSP in Police Department 1. Name of the candidate : 2. Fatherโ€™s Name: Paste here firmly a signed recent passport 3. Signature of the candidate 4. Signature of the Chief size colour photograph Superintendent 5. Identification marks: a) b) Name of the Date & Time Venue of the test Result Test 6. Preliminary selection test Qualified Not Qualified ( 3 km run in 25 minutes) Office Seal & Date Signature of the Chief Superintendent 7. Physical measurement Qualified Not Qualified test Office Seal & Date Signature of the Chief Superintendent 8. Physical efficiency test Attended Not Attended Office Seal & Date Signature of the Chief Superintendent INSTRUCTIONS Stage I : Preliminary Selection Test Candidates will have to run three (3) kms. within 25 minutes 5 PC Rect.2011 in 15th Bn., APSP โ€“ 929/R&T/Rect.1/2011 dt 19-10-2011
  • 6. Stage II : Physical Efficient Test Candidates will have to participate five (5) events i.e., 100 mtrs. run, long jump, shot put, high jump and 800 mtrs. run All candidates hereby advised to get themselves examined by physician and satisfy themselves that they are fit enough to participate in state I and stage II of the selection process OFFICE COPY STATE LEVEL POLICE RECRUITMENT BOARD ANDHRA PRADESH, HYDERABAD Registration No. (to be filled by office only) Identity Card (Office copy) for the posts of SCT Police Constables (APSP) (Men) in 15th Bn., APSP in Police Department 6 PC Rect.2011 in 15th Bn., APSP โ€“ 929/R&T/Rect.1/2011 dt 19-10-2011
  • 7. 1. Name of the candidate : 2. Fatherโ€™s Name: Paste here firmly a signed recent passport 3. Signature of the candidate 4. Signature of the Chief size colour photograph Superintendent 5. Identification marks: a) b) Name of the Date & Time Venue of the test Result Test 6. Preliminary selection test Qualified Not Qualified ( 3 km run in 25 minutes) Office Seal & Date Signature of the Chief Superintendent 7. Physical measurement Qualified Not Qualified test Office Seal & Date Signature of the Chief Superintendent 8. Physical efficiency test Attended Not Attended Office Seal & Date Signature of the Chief Superintendent 7 PC Rect.2011 in 15th Bn., APSP โ€“ 929/R&T/Rect.1/2011 dt 19-10-2011